Depression and Suicide in Children and Adolescents

Depression is underrecognized and undertreated in adolescents, with close to 75% of depressed adolescents not receiving treatment. Untreated depression in adolescence is associated with various adverse adult outcomes, including lower educational attainment and poorer physical health. Beyond the suffering and impaired functioning that depressed adolescents experience as well as the potential for future negative outcomes, the reality is that some affected adolescents commit suicide, further heightening the need for proactive assessment and treatment. Given the persistent shortage of mental health clinicians in the United States, significant emphasis has been placed on increasing the role of pediatricians in addressing this burden. In fact, a key pediatric quality metric that has garnered interest in recent years is screening for adolescent depression in primary care settings. In addition, the American Academy of Pediatrics included recognition and initial management of depression in its 2009 policy statement on recommended mental health competencies in primary care. (1) Given that AUTHOR DISCLOSURE Drs Maslow and Dunlap have disclosed no financial relationships relevant to this article. Dr Chung has disclosed that he serves on an advisory board for Pfizer. This commentary does contain a discussion of an unapproved/ investigative use of a commercial product/ device.